SCOPE OF WORK AAO FY25 PACS UPGRADE.docx

SCOPE OF WORK Albuquerque Area Indian Health Service Picture Archiving and Communication System (PACS) Replacement

1. Purpose

To provide for the Albuquerque Area Office of Environmental Health and Engineering Indian Health Service as well as all Service Units supported across the area with a new and updated PACS enterprise. The intent of this acquisition is to replace our current PACS system with an efficient and effective PACS enterprise that is economical, network secured with proper data integration, appropriately scaled, technician and clinician-focused, and fully proficient of fulfilling the needs and requirements of our radiology departments in accordance with the policies and capabilities of our network infrastructure. Indian Health Service expects that the contractor shall improve and update performance efficiencies and inefficiencies while reducing unexpected maintenance costs by providing an all-inclusive annual support structure that provides all software and hardware updates/upgrades including any required system refresh.

Site Locations: The Albuquerque Area Office Indian Health Service (AAO) currently has 8 Federal PACS sites which include: Albuquerque Service Unit, Acoma Service Unit, Jicarilla Service Unit, Mescalero Service Unit, Santa Fe Service Unit, Zuni Service Unit, Taos-Picuris Service Unit, and Ute Mountain Service Unit. AAO also currently supports two tribal facilities Jemez Service Unit and Alamo Service Unit. All locations have imaging modalities that include general Radiography Systems, Bone Densitometry, Mammography Systems, Computed Tomography, and Diagnostic Ultrasound. All sites are configured to transfer digital imaging studies to the Albuquerque Area office and Diagnostic Imaging Associates with a Backup and Disaster Recovery Archiving accomplished at the Albuquerque Area Office. Improvement options for backup and disaster recovery configurations shall be implemented if deemed beneficial.

Notes of Exception: Jemez is on its own local network and has thier own Health Level Seven contract. Implementation will be installed in accordance with their policies and procedures. Integration for this site will be accounted for.

2. Technical Requirements and Preferences

The requirements are to provide all required hardware and software, installation, configurations, training, and an ongoing full maintenance and support of the PACS enterprise systems. Proposals shall include Service Units’ integration with all modalities and modality vendors across our imaging network. These include Computed Tomography, Mammography, General Radiography, Bone Densitometry, and Diagnostic ultrasound systems from various manufacturers. The PACS proposal shall comply with the Digital Imaging and Communication in Medicine (DICOM) standard for storing, transmitting, and displaying medical images and related information. Currently, our PACS Virtual Machine houses approximately 10 TBs of image data that will require migration.

All proposals must integrate completely with our existing Electronic Health Record System, Health Information System/Radiology Information Systems and Resource and Patient Management System (RPMS). This includes developing and distributing modality worklists to the local imaging devices, while being compatible with VistA (Veterans Information Systems & Technology Architecture) Imaging.

https://www.ihs.gov/vistaimaging/clinicalcapturedisplay/. VistA imaging archiving is done at the Albuquerque Area Office.

NOTE: Alternate solutions to a possible archiving and data storage done without VistA but images are still transferrable to outside civilian and federal hospitals would be beneficial.

All Service Units do not employ Radiologists and will not require diagnostic level workstations at their facilities. The systems shall be focused around the needs of the Radiology Technicians with specific regards to quality control, annotations, and exposure tracking for Mammography. Diagnostic reading services are provided by Diagnostic Imaging Associates. All PACS proposals shall be required to effectively send studies to our contracted reading service and receive those diagnostic reports and images as a package to be stored in the archives. Patient images and diagnostic reports shall be accessible to all Albuquerque Area Service Units clinicians. They shall have access to all of the archived images from all Albuquerque Area Indian Health Service locations. There shall be an efficient and effective means to provide images to patients or outside referral providers. The current methodology is copying to a CD. The information provided below contains a general overview of pertinent requirements related to our network infrastructure and desirable features of a potential PACS solution. The information in this Scope of Work will give interested parties a general overview of technical requirements, end user preferences, and some of the Federal regulations that must be met. This information should aid potential vendors in the development of their proposals.

Albuquerque Area IHS PACS currently consist of:

2 Cluster Node Dell Power Edge Server R330 12 TB.

1 Dell Power Vault 12TB MD1000.

1 Data Base Server Node Dell Power Edge R610.

6 Gateway DICOM Routers.

Proposed PACS Upgrade consist of or similar to physical server each Federal location:

3 Locations - Acoma, Santa Fe and Zuni Service Units.

PACS System, 8 Terabytes Archive, HL7 Interface to RPMS and DIA.

1 Location – Albuquerque Service Unit.

PACS System, 4 Terabytes Archive, HL7 Interface to RPMS and DIA.

4 Locations – Jicarilla, Mescalero, Taos and Ute Mountain Service Units.

PACS System, 2 Terabytes Archive, HL7 Interface to RPMS and DIA.

1 Location – Albuquerque Area Office.

System Back-Up for Redundancy and Disaster Recovery.

2 Tribal Locations – Jemez and Alamo Health Centers.

2.1 General Technical Information

The Albuquerque Area Indian Health Service operates on a Federal Government network. Successful proposals shall meet all Federal Regulations to connect, interface, and integrate with Federal Government networks and all Office of Information Technology (OIT) requirements including but not limited to antivirus architecture, firewalls, access control lists, and all network security management infrastructure. Potential vendors shall be required to have an Interconnection Service Agreement (ISA) in place with the Indian Health Service (IHS) and adhere to Heath Information Management Systems Society /American College of Clinical Engineering / Manufacturer’s Disclosure Statement for Medical Device Security (MDS2), and all relevant requirements of the Health Insurance Portability and Accountability Act (HIPAA). Proposals that may utilize Cloud based data hosting must comply with Federal regulations regarding cloud-based integration systems.

Note: ( Please see the FedRAMP website for information: https://www.fedramp.gov/ ). Private data centers can be used but must be owned and operated by the contractor and not shared with any other entity. All submittals shall include network block diagrams and data flow diagrams of the proposed configurations with pertinent information on quality assurance, uptime guarantees, ongoing service and technical support availability, fully managed service options for subsequent option years, and end user/PACS administrator training.

Bandwidths requirements and Annual Workload estimates of over 50,000 studies essential for the AAIHS PACS. Successful proposals shall be capable of efficient and effective operation within the constraints of the Indian Health Service network infrastructure.

2.2 Technical Aspects and Preferences

The PACS shall not interfere with direct modality image output to DICOM printers/DICOM print servers. The intent is to preserve the means to print directly from modalities as part of a fail-over strategy if the modality-PACS interface or PACS were not functioning, or there is a known need for filmed images at the time a study is performed.

2.2.1. The interface between a modality and the PACS shall not decrease the patient throughput of the modality and shall be based on the DICOM requirements.

2.2.2. The PACS shall be ‘promiscuous’ and support integration of all image acquisition equipment (modalities).

2.2.3. The PACS shall be able to auto-detect and/or auto-configure DICOM connections with user confirmation.

2.2.4. The PACS shall not have any modality integration fees.

2.2.5. The PACS shall have unlimited modality connections.

2.2.6. The PACS shall have unlimited concurrent user licenses.

2.2.7. The PACS shall not have any per user licensing fees.

2.2.8. Site PACS administrators shall have the ability to assign privileges to users without Original Equipment Manufacturer assistance.

2.2.9. PACS shall have Open architecture enabling retrieval of archived/stored images by any device that supports DICOM query and DICOM retrieve.

2.2.10. PACS shall have Provision for redundant archiving and Disaster recovery.

2.2.11. PACS shall have Automatic pre-fetching of related studies from archive/storage.

2.2.12. PACS Shall support basic 3D functionality without requiring the purchase of advanced 3D applications.

2.2.13. The IHS desires that no irreversible compression be performed on an image before primary diagnosis has been completed. It is preferable that images be stored on a permanent basis using a lossless compression method. If compression is used, please provide some detail about compression methods used.

2.2.14. PACS solutions shall integrate with the Radiology Information System via HL7 and/or DICOM for work list to be generated and directed to the proper modalities.

2.2.15. The PACS shall be capable of communicating imaging reports back to the RPMS Radiology package.

2.2.16. The PACS shall have a Mammography Tracking tool for the following locations: Santa Fe Service Unit and Zuni Service Unit.

2.2.17. The PACS may include options to incorporate a Vendor Neutral Archive (VNA) for storage of non-DICOM images and records such as dental x-ray and optometry images. Pricing shall be as an optional feature, and is not a requirement for the proposal’s consideration.

2.2.18. The PACS shall have a Mammography Letter and Bi-Rads single sign on.

2.2.19. The PACS shall have image annotation save/send.

2.2.20. The PACS shall be single sign on and launch from Electronic Health Record.

2.3 Export Capabilities

IHS network, and import images from other sources such as patient provided media from other provider sources (CD/USB/DVD) with proper privileges.

2.4 Information System Integration

2.4.1. The RPMS/PACS interface shall support: Exam order entry transfer from RPMS to the PACS to support pre- fetching, transfer of patient demographic information and Digital Imaging and Communications in Medicine (DICOM) Modality Worklist.

2.4.2. The RPMS/PACS interface shall be bi-directional transfer of radiographic report from RPMS to PACS.

2.4.3. RPMS shall remain the primary source of data and exam order entry.

2.4.4. Vendors shall be responsible for working with on-site and off-site IHS Information Technology Staff, IHS Clinical Engineering Staff, modality vendors, and other vendors/contractors as necessary to ensure acceptable DICOM interoperability and connectivity. On-site work for more than two days shall require an I H S security clearance.

2.5 System Support and User Training

Successful Proposals shall include substantial on-site training for radiology technicians, PACS administrators, and clinician end users. Full warranty and service support in the first year shall be included as well as all software and hardware updates.

2.6 Performance Measures

System reliability shall be at least 98% uptime. Initial response to submitted work requests for system support time shall be less than 60 minutes from initial submission of all request for system support

2.6.1. Expected average retrieval time for clinicians to retrieve stored images must be minimal and specified.

2.6.2. There must be a reliable means for continued operations in the case of network outages. Security and backup archiving shall be structured to ensure no loss of data.

2.6.3. Full cooperative participation in any possible future migration to a new PACS platform shall be required.

2.7 System Security

The PACS shall comply with the HIPAA mandates and all regulatory guidelines. Vendors shall be prepared to discuss their approach to patient data security, encryption methods and compliance with HIPAA requirements.

2.7.1 The system shall support system-wide authentication of users through the use of a unique user-ID and password for each user or through an alternative approach with equivalent result.

2.7.2 Ability to utilize the IHS LDAP (Lightweight Directory Access Protocol) interface for user-ID and password is optional but is preferred by agency.

2.7.3 Ability to utilize HSPD-12 (Homeland Security Presidential Directive 12) cards for double-authentication is optional but is preferred by agency.

2.7.4 Ability to enable/disable system-wide authentication on a user by user basis by the PACS administrator shall be available. The intent of this is to be able to disable this feature during authentication system communication failures to still allow for the review of images by otherwise authenticated users

2.7.5 Systems shall comply with all applicable IHS security and privacy regulations, as well as applicable non-IHS laws and regulations such as HIPAA, and to the extent possible, FISMA (Federal Information Security Management Act). IHS Information Technology staff to provide links or documentation for IHS regulations and specify other regulations to be addressed in addition to HIPAA

2.7.6 Systems shall include a CD/DVD burner for all locations

2.7.7 Systems shall have complete audit trails that include tracking when an individual sends images to an external device such as a CD/DVD burner or external hard drive/flash drive

2.7.8 Systems shall allow for the ability to prevent images from being sent to an external device such as a CD/DVD burner or external hard drive/flash drive without proper privileges

2.7.9 Active Directory compatibility shall be identified.

2.8 Delivery Targets

The PACS replacement completion target is within 90 days after award of contract. Payment shall be made upon full completion of all PACS installations, training, deployment and acceptance of the project by IHS Project Officer.

2.9 Service- Yearly Options

Full Service and Support options in the years beyond warranty coverage will be renewed annually, at the option and discretion of the Albuquerque Area Office Indian Health Service and the availability of funds in that years. Invoicing shall be performed on a quarterly basis itemized towards individual service unit’s usage. Each location shall be billed on separate lines of the invoice. Service and Support shall be all inclusive, full managed services to include 24/7 remote monitoring, technical service and support, and all hardware, software, updates, and upgrades.